This application was development to test the following hypothesis: A medical model of periodontal therapy, when compared to a traditional model, is as clinically effective, is more valuable, and can be realistically implemented in clinical practice. To accomplish this task we will carry out a prospective, blinded, matched, community-based, cohort trial. Two analytical techniques will be employed to compare the outcomes of periodontal therapy: clinical effectiveness and value. The two primary outcomes variables for assessing clinical effectiveness will be clinician centered (attachment level) and patient centered (quality of life). The key outcome variable for value determination is cost of care. Value is then determined by dividing the outcomes by the cost of care. Thus a similar outcome at reduced cost increased value. This facilitates calculating cost-effectiveness and cost-utility of care, preparing decision analysis trees, and carrying out sensitivity analysis. There are two significant reasons for testing a medical model of care. If our hypothesis is correct (1) this would increase access to periodontal care; and (2) it would offer a cost-effective method to treat periodontal infections that are correlated with systemic health problems. These points argue for a direct comparison of the medical and traditional model of care.